Disease we should all be talking about

LOOK at almost any cancer and you will see that survival rates are improving. Growing awareness about symptoms and better treatments are driving death rates down but, worryingly, mouth cancer is bucking the trend.

This form of the disease claims about 2,000 lives a year and cases are up by 25 per cent over the last decade.

It is also clear the disease, once considered an old man’s condition and linked mainly to smoking, is affecting more young people than ever. A quarter of cases are now in the under-55s.

Among women, too, the trend is steeply upwards, although two thirds of cases are still men. Sufferers of the condition include actor Michael Douglas and former England cricketer Geoffrey Boycott.

At a time when smoking is on the decline experts are looking wider for the reasons for these dramatic increases. Growing alcohol consumption is pinpointed as the main explanation.

Two glasses of wine or two strong pints of beer a day can treble the risk of mouth cancer. That is only just above the recommended limits.

Mouth cancer cases have hit an all time high but, early signs are often missed

Hazel Nunn of Cancer Research UK says: “It’s not just people who binge drink who put themselves at risk but those who drink steadily throughout the week without getting drunk.”

However it’s not the only reason. Poor diet is another lifestyle factor and a new study suggests we should eat more vegetables from the cruciferous family (including cauliflower, broccoli, sprouts and cabbage) to reduce the likelihood of mouth cancer. Up to a third of cases could be a result of poor diet.

The impact of the human papillomavirus (HPV), which can be transmitted via oral sex, is less clear. Experts suggest it may rival tobacco and alcohol as a major mouth cancer cause within 10 years. The importance of some strains of the virus in causing mouth cancer cases is not entirely clear because not all hospitals test for HPV. It is also thought this common virus, which is usually harmless, can be transmitted in other ways.

The British Dental Health Foundation is launching a campaign next month to raise awareness about mouth cancer symptoms. These include persistent ulcers and red or white patches in the mouth.

Cancers of the lip, tongue and throat all come under the mouth cancer umbrella and Hazel adds: “We’d like people to occasionally have a little look at the inside of their gums and cheeks.

“If there’s anything unusual or they have an ulcer that doesn’t go away after two or three weeks they should go to their dentist even if not due for a routine check-up.”

There are also calls from cancer experts for better ongoing training for dentists to recognise the warning signs and take action.

Seven out of 10 cases of oral cancer are detected late and about 50 per cent do not survive for more than five years. In the field of mouth cancer there has been no discovery of a “wonder drug” and treatment often involves major surgery. It can leave patients disfigured and with severe side effects, such as speech and swallowing defects.

In one breakthrough researchers from Queen Mary, University of London, have developed a new gene test that can detect pre-cancerous cells in people with mouth lesions.

GORDON MULLEN first noticed a small but persistent red patch on his tongue which burned when he ate spicy food or drank alcohol.

The IT worker was fit, never smoked and enjoyed only the occasional glass of wine or beer. So he pushed the symptom to the back of his mind.

“It got worse and the patch turned white,” recalls the 42-year-old. “I was half hoping my dentist would notice it during my next routine check-up but nothing was mentioned and I felt reassured.”

Eventually, about a year later, he decided to draw his dentist’s attention to the problem and this time was sent for a biopsy.

Gordon, from Bellingham, Northumberland, was initially given the all-clear and the patch was blamed on an allergic reaction to a gold crown. However when he began consultations to have the crown replaced, alarm bells rang.

“During one fitting session the dentist accidentally touched my tongue with one of the tools and the pain was so bad I almost hit the roof,” he says. “I could see she was worried so I asked to be referred for a second biopsy.

“When I was diagnosed with stage two mouth cancer I already had an inkling of what was coming. I thought there was nothing I could do and I was going to die.”

In 2008 Gordon had surgery to remove part of his tongue. Diseased lymph nodes were also removed, leaving him with a 15in scar stretching from under his chin round his neck. The operation was followed by radiotherapy and chemotherapy.

Treatment was successful but Gordon has been left with a lisp, a permanently dry mouth and has difficulty swallowing.

His gullet, which normally helps food pass into the stomach by a squeezing movement, no longer functions fully. His taste buds are also affected, leaving many foods and drinks tasting very bitter.

Gordon, who is single, says: “I get tongue-tied pronouncing some letters such as D which is annoying because there’s one in my name.

“All my food has to be soft and mushy so I eat a lot of smoothies and soup. You forget how much of your social life revolves around eating and drinking. I miss the simple things such as fish and chips or biting into an apple.”

Gordon, who lost 4st after treatment, believes his first dentist should have been more alert to the warning signs and wants everyone to be aware of the symptoms.